Writer: Joshua Andino
2 min read March 2023 — This week, the North Carolina Senate passed a bipartisan agreement to expand Medicaid to low-income adults, voting 44-2 to complete approval of the legislation.
The passage comes a week after Democrat Gov. Roy Cooper outlined the expansion as a priority, telling the legislature in his final State of the State address, “One of the ways we are seizing that moment is by expanding Medicaid. I’m grateful for our unified Democratic legislators and some Republicans who have been relentless for years in this effort to expand Medicaid. I commend the Republican leadership of this legislature for now embracing this and coming together in agreement….When we get Medicaid expansion across the finish line, it will save lives.”
Medicaid expansion has been a priority for the governor since taking office, with momentum building as previous attempts to address similar concerns fell through, leading Republicans to come around to striking a deal earlier this month. “This is something that we can all be very proud of,” said House Speaker Tim Moore at a press conference alongside Senate leader Phil Berger. “What a huge announcement this is for North Carolina. What a huge policy direction this is that will provide help for so many in this state, but it’s going to do it in a way that’s fiscally responsible.”
The legislation the senate passed would direct state officials to accept expanded Medicaid coverage as provided for by the Affordable Care Act. It now moves to the House, where it will likely be voted upon next week at the earliest. Earlier in the month, Speaker Tim Moore said House floor votes would resume next Wednesday.
Currently, North Carolina has 2.9 million enrollees in Medicaid, and is one of 11 states that has yet to expand coverage. Up to 600,000 North Carolinians between the ages of 18-64 could qualify for expanded coverage, while the states’ 10% share of the new expense would be paid for through hospital assessments
The legislation would also scale back the “certificate of need” regulations that require state regulators to sign off on additional beds for mental health or purchase MRI machines. Other components of the bill would direct the Department of Commerce to work with stakeholders for a comprehensive workforce development program.
It remains to be seen whether changes will take effect immediately, as the governor has aimed, or would only be implemented once a new state budget has been passed.
Gov. Cooper has argued that failure to pass expansion immediately would mean the state losing out on billions of federal dollars, saying in his address that, “Every month we wait to expand not only costs lives but costs our state more than $521 million dollars a month in federal health care dollars. And if we don’t expand soon, we will forfeit an additional $1.8 billion in Health Care Access and stabilization or HASP funds that our hospitals will never get back, and that would be particularly hard on our rural hospitals.” He added, “For mental health. For working families. For rural hospitals. For a healthier North Carolina. For $1.8 billion we can’t afford to leave behind. Let’s expand Medicaid now.”
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